血清骨转换标志物下降与绝经后妇女腰椎骨密度的短期正向变化相关。

Declining serum bone turnover markers are associated with the short-term positive change of lumbar spine bone mineral density in postmenopausal women.

机构信息

Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology, Guangzhou, China.

出版信息

Menopause. 2022 Jan 31;29(3):335-343. doi: 10.1097/GME.0000000000001920.

DOI:10.1097/GME.0000000000001920

PMID:35102102

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8862778/

Abstract

OBJECTIVE

While serum bone turnover markers (BTMs) and bone mineral density (BMD) have been confirmed as useable risk assessment tools for postmenopausal osteoporosis, the associations between BTMs and BMD changes are still ambiguous. The aim of this study was to explore the underlying associations between BTMs and BMD changes in postmenopausal women.

METHODS

Between January 2015 and October 2020, 135 postmenopausal women were retrospectively enrolled. They were divided into two groups according to lumbar spine (LS) 1-4 BMD change (1 y T-score minus baseline T-score, Group 1 [n = 36] < 0 and Group 2 [n = 99] ≥ 0). The changes of BTMs (N-terminal middle segment osteocalcin [N-MID], propeptide of type I procollagen [P1NP], and β-C-terminal telopeptide of type I collagen [β-CTX]) and their associations with LS 1-4 BMD change were analyzed. The biochemical indices and clinical parameters related with LS 1-4 BMD change were also evaluated.

RESULTS

The 1 year N-MID, P1NP, β-CTX and Phosphorus in Group 2 were lower than those in Group 1 (P < 0.05), their changes within 1 year were significantly negatively correlated with LS 1-4 BMD change (R2 = -0.200, P < 0.001; R2 = -0.230, P < 0.001; R2 = -0.186, P < 0.001; R2 = -0.044, P = 0.015; respectively). Except for the Phosphorus change (area under the curve [AUC] = 0.623), the changes of N-MID, P1NP, and β-CTX and their 1 year levels had similar AUC to diagnose the short-term LS 1-4 BMD change (AUC > 0.7 for all, with the AUC of 1 y P1NP being the largest at 0.803). Binary logistic regression analysis showed that the physical activity and drug intervention were the determinant factors for the LS 1-4 BMD change (odds ratio = 6.856, 95% confidence interval: 2.058-22.839, P = 0.002; odds ratio = 5.114, 95% confidence interval: 1.551-16.864, P = 0.007; respectively).

CONCLUSIONS

Declining N-MID, P1NP, β-CTX, and Phosphorus are associated with the short-term increase of LS 1-4 BMD within 1 year. Physical activity and drug intervention are factors significantly influencing the change of LS 1-4 BMD in postmenopausal women.

摘要

目的

虽然血清骨转换标志物（BTMs）和骨密度（BMD）已被证实可用于绝经后骨质疏松症的风险评估，但 BTMs 与 BMD 变化之间的关系仍不明确。本研究旨在探讨绝经后妇女 BTMs 与 BMD 变化之间的潜在关系。

方法

回顾性纳入 2015 年 1 月至 2020 年 10 月期间的 135 例绝经后妇女。根据腰椎（LS）1-4 BMD 变化（1 年 T 评分减去基线 T 评分，组 1[n=36]＜0 和组 2[n=99]≥0）将其分为两组。分析 BTMs（N 端中段骨钙素[N-MID]、I 型前胶原肽[P1NP]和 I 型胶原β-末端肽[β-CTX]）的变化及其与 LS 1-4 BMD 变化的关系。还评估了与 LS 1-4 BMD 变化相关的生化指标和临床参数。

结果

组 2 的 1 年 N-MID、P1NP、β-CTX 和磷在第 1 年低于组 1（P＜0.05），其 1 年内的变化与 LS 1-4 BMD 变化呈显著负相关（R2=-0.200，P＜0.001；R2=-0.230，P＜0.001；R2=-0.186，P＜0.001；R2=-0.044，P=0.015）。除磷变化（曲线下面积[AUC]=0.623）外，N-MID、P1NP 和 β-CTX 的变化及其 1 年水平对短期 LS 1-4 BMD 变化的诊断具有相似的 AUC（所有 AUC＞0.7，1 年 P1NP 的 AUC 最大为 0.803）。二元逻辑回归分析显示，体育活动和药物干预是 LS 1-4 BMD 变化的决定因素（比值比=6.856，95%置信区间：2.058-22.839，P=0.002；比值比=5.114，95%置信区间：1.551-16.864，P=0.007）。